Roofing Form – Socal Renewable

Claim Your $2/per Sq Ft Rebate on a New Home Roofing

Fill out the form below to check your eligibility.

Prefix

First Name *

Middle Name

Last Name *

Phone Number *

Email Address *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Associate Name0 / 250

Approximate Roof Size *

Roof Type *Asphalt ShingleFlatMetalTile

Current Roof Condition: *Aging (10–20 years)Leaking / urgentFull replacement neededMinor repairs needed

How many layers? *21Not Sure

What do you need? *Full replacementInspection onlyRepair

Are there leaks? *YesNo

Additional Work Needed (checkboxes):Plywood replacementInsulation upgradeNew guttersSkylights / vents

Utility Provider *LADWPSCENone

Utility Account Number

cost_before_rebate

rebate_amount

total_cost

Rebate

CONGRATULATIONS — YOU QUALIFY FOR: ${calculation-6}

(BASED ON CALCULATOR AND SQUARE FOOTAGE OF YOUR HOME ROOF INPUT DURING THE APPLICATION PROCESS)

Invoice

Total Due Now: ${calculation-2}

After Utility Rebate: -${calculation-6}

Net Cost: $ {calculation-7}*

*Pending site inspection and eligibility.

Expect your mail-in rebate in 2-4 weeks after installation*

Credit / Debit Card *Pay Net Total

California Contractor license number 1138642

Terms & Conditions